The Pain of Marathons: Pain in the Knees

You have resolved during the New Year to become more health conscious (like every other year) and embark on a brand new exercise regime. That's well and good, but are you pushing yourself too hard unwittingly? You could be setting yourself up for repetitive strain injuries.

"Repetitive strain injury refers to injury sustained from continuous cycles of overuse or overexertion, especially when the body is unaccustomed and unable to cope with such constant demand," explains Dr Leon Foo, an orthopaedic surgeon at Mount Elizabeth Hospitals, Singapore.

Common repetitive strain injuries

Runner's Knee

Also known as Anterior Knee Pain, runner's knee is an inflammation of the underside of the knee. It is so named as it is a common problem amongst people who run long distances, or participate in sports with a lot of jumping. This condition results in a dull pain in front of the knee cap, which is aggravated by squatting, running, and walking up and down stairs.

Golfer's Elbow

Golfer's elbow is the inflammation of one of the tendons that join the forearm muscles to the elbow. It usually results in pain on the inside of the elbow whenever the wrist or fingers are exerted. Despite the name, this condition is not limited to people who play golf. In fact, any exercise or sport where the wrist is being used repeatedly, such as swinging a racket in racket sports or when lifting weights at the gym, can cause golfer’s elbow.

Carpal Tunnel Syndrome

While this condition has become popularised in recent years as one facing 'keyboard warriors', the fact is that this problem can be caused by any sport where there is repetitive exertion and flexing of the wrist, especially racket sports. This syndrome is where the median nerve, a major nerve in your hand, is squeezed and unable to function properly due to an inflammation of the tendons in the carpal tunnel of your wrist. This results in pain and numbness of your hand.

Trigger Finger

Trigger finger is a condition where there is a pain at the base of the finger, especially when trying to bend or straighten the finger. The tendon in the finger is inflamed and swollen, and it can often result in the finger being 'locked' in a bent position, hence the name. One of the many causes of trigger finger is an 'overuse' of the finger, and it can be commonly found amongst those who play basketball regularly.

Left untreated, such injuries can even prove disruptive at work and prevent a person from performing common activities if the condition is serious enough.

Preventing strain injuries while exercising

Thankfully, there are ways that you can prevent repetitive strain injuries while exercising. Here are several tips from Dr Foo:

Know your limits

If you are already feeling a strain, the first thing to do is to stop the activity that is causing the pain. Muscles can't be built in a day, or even a week, so it is important to know your limits.

Vary your routine

Rather than doing a single activity repetitively, try to vary your routine and aim for a more balanced workout. By working different muscle groups in turn, you will give tired muscles a chance to recover.

Proper warming up

Take time to warm up properly. Stretch different parts of the body and perform a range of motion exercises. Warming up prepares the body by increasing the blood flow to the muscles, which allows them to loosen up.

Correct exercise techniques

"When in the gym, a personal trainer can guide you through the correct use of the many devices and equipment so that you will not end up with injuries," says Dr Foo.

Dress appropriately

Protect yourself with appropriate, supportive footwear and protective aids such as joint or muscle supports, tapes or straps. A knee guard, for example, can help prevent knee joint problems.

Take time

Last but not least, take time to build up your training tempo gradually. "Establish reasonable targets within reasonable time frames. Overexercising results in fatigue, which in turn increases the risk of repetitive strain injuries," says Dr Foo.

See a doctor

If you are already suffering from one of the repetitive strain injuries mentioned earlier, you should always see a specialist. Repetitive strain injuries like runner's knee and golfer's elbow can be treated through physiotherapy and medication, and physiotherapy can also help tailor a suitable fitness regime to help ensure that the problem does not come back.

"For instance, if you notice that overhead exercises aggravate your shoulder, and then avoid these movements until your shoulder pain stop," advises Dr Foo.

For more serious cases of carpal tunnel and trigger finger, there are minimally invasive techniques available to minimise the trauma to your body and reduce the recovery time. Carpal tunnel release involves cutting the carpal ligament to reduce the pressure on the median nerve. It can be done with a minimally invasive cut on your wrist, and is often a day surgery. Similarly, trigger finger surgery is usually performed as a day surgery. Using a minimally invasive cut, the swollen and inflamed portion of the tendon is removed to release the pressure, allowing your finger to function normally and without pain.